Now that Michael Phelps and the Olympics are finally over, we can get back to the really important stuff like, "So when am I going to die?" I am reminded of an event that took place several months ago when a member of my ward had an episode that prostrated him on the floor of the bathroom. I arrived shortly after the paramedics did and we gave the fellow a blessing. The frantic wife, after the blessing, asked me imploringly, "Is my husband going to die?" I said "Yes..... But probably not today." Trillium found this piece of unveiled humor particularly macabre and thought that I ought to avoid it in the future. I have been moderately successful, but I am having some difficulty pulling it off on this blog.
As I have indicated before, the treatment, if not the cure, for hemochromatosis is phlebotomies, or "blood-letting". The recommendation is to take a pint or two for several weeks until the ferritin level drops to almost the "anemic" level, and then draw a pint about once a quarter thereafter. As the body regenerates the new blood, it looks around for stored iron in order to make the blood capable of carrying the oxygen to all the tissue in the body. Iron binds with oxygen and releases the oxygen once it arrives at the proper locations. Without iron, the oxygen could not be carried about easily. Iron-overloading, as it turns out, does little to provide more oxygen. Getting back to my point; it is the creation of new blood that requires more iron. The more blood that is drawn, the more the body has to draw on those stored iron molecules. After a while, most of the stored iron is extracted and tissues like the kidneys, the liver, and the pancreas return to normal. So, the patient has the blood drawn, drinks vast amounts of fluids (preferably not Mountain Dew, Chris), and then waits upon nature to deliver him from the normal effects of hemochromatosis. Typically, the drawing of a pint of blood reduces the ferritin level by 40 or 50 points. Inasmuch as my ferritin level was (perhaps is) at 827, I would need to have about 16 pints of blood drawn. This works out to about four months of treatment by following the recommended technique. Some physicians recommend two pints a week; at that rate I would be at a normal ferritin level in about eight weeks. There are obviously far more radical treatments possible, but the chances of survival begin to wane considerably.
In conjunction with phlebotomies, the standard treatment also encourages improved eating habits. Red meat is discouraged, wiping out such delicacies as rack of beef ribs, tri-tip steak, any $6.00 burger, anything from the Sizzler menu, liver, beef tongue, kidney pie, blood sausage, menudo, chicken feet, flank of horse, seal flippers, and any more than six ounces of whale blubber at a time. In the spirit of the appropriate diet for my condition, I decided to exclude the last nine items from my repasts.
Oddly enough, taking over-the-counter vitamin C tablets is discouraged, the reason being that vitamin C facilitates the absorption of non-heme iron. Thus, if I were to consume the "Green Drink" with 2000 or 3000 units of vitamin C (which I have done on occasion), it would be tantamount to injecting 20 ounces of bacon fat into my jugular vein. So, as a result, my morning ritual of pill popping has been simplified by one letter of the alphabet. Also, vitamin C will cause the heart to store abnormal amounts of iron, causing a rather irksome "clanking" sound every time there should be a tender "thump". Finally, the vitamin C will facilitate the storage of iron in the joints, welding the bones together with arthritis, causing further "clanks", "clunks", and "squeaks". Needless to say this can be unnerving to anyone within a seven-block radius.
Sushi is a "no-no"; a real heart-breaker that! A hemochromatosis patient should not even handle raw seafood. While this allows me to scurry out of the kitchen whenever the halibut appears, there is another downside to this particular problem. I can no longer walk on the beach barefoot. There is in sea water a bacteria called "Vibrio vulnificus" which, when it encounters stored iron is catastrophically toxic. Never mind about the Great White out there just beyond the breakwater; that big toothy guy is part of the treatment. Imagine, one bite and Wow!, a whole bunch of stored iron instantaneously gone, with aggravated phlebotomies as a chaser. Some things just seem counter intuitive.
Green tea inhibits absorption of iron of any kind. It is the tannin in tea that does the trick. Green Tea HP, a single cup of which is equal to 52 cups of regular tea, will dissolve an Abrams tank in fifteen minutes, so think what it would do to the stored iron in your body. Patients must understand that this will not be a replacement for protocol treatments, but will provide some entertainment value for the the nurse assigned to the task of taking your blood. How much fun would it be to draw a pint from a highly agitated moving target with a 14-gauge needle? It provides sufficient inducement for acquiring a stun-gun with 15 ccs of Demerol, I'll tell you.
So, with all of this information before me, how is that the day after I had my first pint drawn that I found myself at the home of Barbara and Jay eating a half-pound of tri-tip steak? Barbara had invited Trillium and I to their place because of some service that we and several neighbors had rendered to them. I was asked to grill the meat, which I did. Grilling ten pounds of tri-tip will disorient anyone, regardless of the diseases with which they may or may not be afflicted. I considered marinating the meat in Green Tea HP, but thought that B-J really wanted to have a subdued get-together.
Last Friday, suffering from an extreme case of cabin-fever, I invited Trillium to lunch. We decided to go to Kneaders, a place where the sandwiches are completely iron-free, so long as you eat only the lettuce and avoid the lemonade. BYU was in the midst of Education Week and the place was packed. We left without parking. "Where shall we go? Trillium asked. I said that there was another Kneaders in north Orem. As we pulled back onto Bulldog Avenue (named for the mascot of Provo High School) she said, "How about there?" Like Pavlov's dog, I started drooling. "You mean it? (slurp, slurp)" "Sure. What would you have if we ate here?" I knew that this was a test. I thought for a nanosecond and replied, "I would have the $6.00 Guacamole Bacon Burger, with fries and a lemonade (clank, clunk, squeak)". I really said that as a joke, thinking that I would have something else less ferrous. I could not resist, however, when it came time to order. After I took my first bite, I began to feel faint; my head was swimming, Trillium thought that I was having a stroke. "What's wrong with you?" she queried. "Twenty ounces of bacon fat!" I gasped. Trillium looked a little frantic, "Is my husband going to die?" "Yes," I said,".... but probably not today."
Waters Blue - This morning I was prancing through the text of the first volume of my autobiography, in preparation for its printing in a month or so. As I was reviewing...
7 years ago